Head, Neck, Back, and Spine Flashcards
Components of head et neck
SCALP
Skin: sebaceous/sweat glands
Connective Tissues: major arteries et veins
Aponeurosis: connects ms
Loose areolar tissue: emissary veins
Periosteum: inner portion of scalp
Axial (80)
Skull
Vertebrae
Ribs
Sternum
Coccyx
Ear ossicles
Appendicular (126)
UE
LE
Components of Ear Ossicles
HIM / MAS
Hamer - Malleus
Incus - Anvil
Stapes - stirrups
Skull: Cranial bones
Parietal
Temporal
Frontal
Occipital
Ethmoid
Sphenoid
Paired cranial bones
Parietal and Temporal
Most difficult to visualize cranial bone
Sphenoid
not paired facial bones
Vomer and Mandible
Skull: facial bones
Nasal
Inferior nasal conchae
Lacrimal
Palatine
Zygomatic
Vomer
Maxilla
Mandible
Sutures
Coronal
Sagittal
Lambdoidal
Anterior fontanelle closes at what month?
18-24 mos
Post closes at what month
9-12 mos
Anterior fontanelle is called ______ if closed
bregma
Posterior is called ______ if closed
lambda
(+) elevation=?
hydrocephalus
(+) depression/sunken fontanelle=?
dehydration
Anatomical Landmarks
Nasion
Pterion
Inion
Glabella
Philtrum
Depression at roof of nose
Nasion
Lateral portion of skull
Thinnest area
Pterion
External occipital protuberance
bump of knowledge
Inion
b/w eyebrows
glabella
b/w upper lip et nose
philtrum
Muscles of the head:
for facial expressions
Occipital frontalis
Corrugator Supercilii
Procerus
Zygomatic major and minor
Levator anguli oris
Risorius
Orbicularis Oris
Buccinator
Mentalis
Levator labii superioris
Platysma
Muscles for eye opening
Levator palpebrae superioris - 80%
Mueller’s muscle - 20%
Muscle for eye closing
Orbicularis oculi
What facial ms?
- raises eyebrows
- last to recover in Bell’s Palsy
- Surprise ms
Occipital frontalis
What facial ms?
- frowning
Corrugator Supercilii
What facial ms?
- nose scrunching
- distaste
Procerus
What facial ms?
- sneering ms
Levator anguli oris
What facial ms?
- grimace
- if absent? =
Risorius
= dimple
What facial ms?
- for kissing
Orbicularis Oris
What facial ms?
- blowing
- sucking
- whistling
Buccinator
What facial ms?
- pouting
Mentalis
What facial muscle?
- elevates upper lip
Levator Labii Superioris
What facial ms?
- “egad” ms
- ms of horror
- pulls neck downward
Platysma
What facial ms?
- protrusion of lower lip
Depressor anguli oris
EOM_
SO_
LR_
EOM3
SO4
LR6
EO Muscles
SR
LR
IR
IO
MR
SO
Muscles activates if a person looks straight?
all of the eoms
Point of entry/exit of CN
- cribriform plate
CN 1
Point of entry/exit of CN
- optic canal
CN 2
Point of entry/exit of CN
- Superior orbital fissure
CN 3,4 5v1, 6
Point of entry/exit of CN
- Foramen rotundum
CN 5v2
Point of entry/exit of CN
- Foramen ovale
CN 5v3
Point of entry/exit of CN
- Internal acoustic meatus
CN 7,8
Point of entry/exit of CN
- Jugular Foramen
CN 9,10,11
Point of entry/exit of CN
Hypoglossal Canal
CN 12
Atlas
no body
no spinous process
C1
Axis
(+) dens
Atypical
fx: hangman’s
C2
Hyoid
C3
Thyroid
C4
most mobile
C5 et C6
most mobile
cricoid
C6
prominent
long
non bifid
C7
Schober’s test landmarks
C7-S2
How to stretch L torticollis?
R lat flexion
L rotation
torticollis to the L
R SCM
L torticollis
L SCM
What bone?
-no muscle attachment
- stabilized by what ligament?__________
Hyoid bone
stylohyoid ligament
Action of SCM?
i/l lateral flexion
c/l rotation
How to stretch SCM?
c/l lateral flexion
i/l rotation
Action of Scalenes?
i/l lateral flexion and rotation
Syndrome involving scalene ms?
R scalenus anticus syndrome
- Synovial joint
- modified hinge joint (2 joints)
TMJ
Action of superior TMJ?
translational sliding/gliding
Action of inferior TMJ
Rolling
Normal range for TMJ elevation?
close mouth
N Depression of TMJ
35-55mm
3 finger breaths
N Protrusion of TMJ
3-6mm
N retrusion of TMJ
3-4mm
N lateral deviation/excursion
10-15mm
N amount of mastication
18mm
Muscles of Mastication
CN 5
(TIME)
Temporalis
Internal Pterygoid
Masseter
External Pterygoid
Muscles of mastication for closing
Temporalis
Internal Pterygoid
Masseter
Muscles of mastication for mouth opening
External Pterygoid
Muscles in Lateral deviation of jaw
Lateral pterygoid (I/L)
med/int pterygoid (C/L)`
R Lateral deviation of jaw
R lateral pterygoid
L medial pterygoid
Muscles of the Tongue
- action?
- CN?
Palatoglossus - elevation; CN 9 et 10
Genioglossus - protrusion; CN 12
Hyoglossus - retrusion; CN 12
Styloglossus - curling; CN 12
Function of Back et Spine
(SIRENA)
Supports head
Important attachment of muscles, ligaments of spine
Ribs attachment
Encloses spinal cord
Nagprovide ng mobility + flexion of spine
Ability to transfer weight from head -> spine -> extremities
Diameter of vertebral column in
Females?
Males?
M: 72cm
F: 62 cm
How many total vertebrae are there in a child?
-Cervical
-Thoracic
-Lumbar
-Sacrum
-Coccyx
Total = 33
-Cervical: 7
-Thoracic: 12
-Lumbar: 5
-Sacrum: 5
-Coccyx: 4
How many vertebrae are there in adults?
-Cervical
-Thoracic
-Lumbar
-Sacrum
-Coccyx
Total= 26
-Cervical: 7
-Thoracic: 12
-Lumbar: 5
-Sacrum: 1
-Coccyx: 1
What are the typical vertebrae
C3-C6
T4-T8
L1-L4
Vertebral body of (size)
- Cervical
- Thoracic
- Lumbar
- Cervical: small
- Thoracic: med
- Lumbar: large
Spinous process of
- Cervical
- Thoracic
- Lumbar
- Cervical: short, bifid
- Thoracic: long, inclined downward
- Lumbar: short, flat, quadrilateral
Transverse process of
- Cervical
- Thoracic
- Lumbar
- Cervical:
transverse foramen: vertebral aa, vertebral vein, sympathetic nn - Thoracic
costal facets - Lumbar
conical
Spinal column of
- Cervical
- Thoracic
- Lumbar
- Cervical: largest, triangular
- Thoracic: smallest, circular
- Lumbar: triangular
Facet joints of
- Cervical
- Thoracic
- Lumbar
- Cervical
Sup: sup et post
Inf: ant et inf
perpendicular to sagittal plane - Thoracic
Sup: lat-post
Inf: med-ant
perpendicular to frontal plane - Lumbar
Sup: med
Inf: lat
perpendicular to sagittal plane
Angle of inclination of
- Cervical
- Thoracic
- Lumbar
- Cervical: 45 deg
- Thoracic: 60 deg
- Lumbar: 90 deg
What are the atypical vertebrae
C1
C2
C7
T1
T2-T4
T9-T10
T11-T12
L5
What atypical vertebrae?
- atlas, no body, no SP
C1
What atypical vertebrae?
- axis, (+) dens (odontoid), large, bifid SP, short TP
C2
What atypical vertebrae?
- long, non-bifid SP
- vertebral prominence
C7
What atypical vertebrae?
- horizontal SP, costal facets (sup vertebral body)
T1
What atypical vertebrae?
- almost horizontal spinous process
T2-T4
What atypical vertebrae?
- (+) tubercles
- landmark for xiphoid process
T9-T10
What atypical vertebrae?
- costal facets
- outer pedicle
T11-T12
What atypical vertebrae?
- short transverse process
L5
- Yes joint
- flexion et extension (how many %)
- What type of joint?
- AO
- 50%
- condyloid jt
- No joint
- rotation (how many %)
- what type of joint?
- AA
- 50%
- pivot/trochoid jt
Displacement of Nucleus Pulposus
Disc herniation
Stages of disc herniation
BPES
1. Bulging/protrusion: intact AF
2. Prolapse
3. Extrusion: complete tear of NP but still inside
4. Sequestration: NP went out
Most common direction of disc herniation?
Why?
- Post
- PLL tapers posteriorly/inferiorly
Protein found in Nucleus Pulposus?
how many % of H2O?
Proteoglycans
80%
Protein found in annulus fibrosus
lamellae
Ligament of spine:
- limits extension of spine
ALL (Anterior Longitudinal Ligament)
Ligament of spine:
- limits flexion of spine
PLL (Posterior Longitudinal Ligament)
Ligament of spine:
- connects tips of spinous process
- T1 below
Supraspinous ligament
Ligament of spine:
- yellow ligament- connects adjacent lamina
Ligamentum flavum
Ligament of spine:
- b/w spinous process of adjacent vertebrae
Interspinous ligament
Ligament of spine:
- b/w transverse process
Intertransversarii
Ligament of spine:
- connects SP of C7 to occiput; traps
Ligamentum nuchae
Ligament of spine:
- skull to atlas
- limits rotation
Alar ligament
Ligament of spine:
- prevents posterior subluxation of C2
Transverse ligament
Ligament of spine:
- connects foramen magnum to apex of C1
Apical Ligament
Superficial muscle of back:
- UR
- Shawl ms
Trapezius
Superficial muscle of back:
- UR
- retraction
Levator Scapulae
Superficial muscle of back:
- EXADDIR
- crutch walking ms
Latissimus Dorsi
Superficial muscle of back:
- UR
- retraction
Rhomboids
Intermediate muscle of back:
- forced inspiration
- forced expiration
- Serratus Posterior
- sup
- inf
Deep muscle of back:
- “bandage”
- neck?
- head?
- splenius
- capitis
- cervicis
Deep muscle of back:
- Erector spinae muscles
(I Love Se-)
Iliocostalis
Longissimus
Spinalis
Deep muscle of back:
- Transversospinalis
Semispinalis
Multifidus
Rotatores
What muscle elevates lower ribs?
Levatores Costarum
What muscle is tight if (+) forward head?
Suboccipital muscles
Anterior group muscles
- add, IR
- depresses shoulder
- pec major
- pec minor
Anterior group muscles
- boxer’s ms; saw ms
Serratus Anterior
Anterior group muscles
- core ms
- upper: sit ups
- lower: double leg raise
Rectus abdominis
Anterior group muscles
- core ms
- corset ms
Transversus abdominis
Anterior group muscles
- core ms
- Internal (I/L)
- External (C/L)
Obliques
Lateral group muscles
Quadratum lumborum
Psoas major
Landmark for C3
Hyoid
Landmark for C4
Thyroid
Landmark for C6
cricoid
What are the 9 Cartilages?
Thyroid
Cricoid
Arytenoid - 2
Corniculate - 2
Cuneiform - 2
Epiglottis Sphincter fxn
Sing Voltes Spine
Char
Flexion of
AO
AA
C3-C7
Thoracic
Lumbar
10
5
45
15
40
Extension of
AO
AA
C3-C7
Thoracic
Lumbar
25
10
45
15
25
Lateral Flexion of
AO
AA
C3-C7
Thoracic
Lumbar
L et R: 5
L et R: 10
L et R: 30
15
20
Lateral Flexion of
AO
AA
C3-C7
Thoracic
Lumbar
L et R: 5
L et R: 10
L et R: 30
15
20
Rotation of
AO
AA
C3-C7
Thoracic
Lumbar
L et R: 0
L et R: 45
L et R: 30
L et: 40
L et R: 5
